– Discussion: – RA may cause symptoms because of pressure and location; – nodules may be cosmetically unacceptable; – nodulosis occurs in 20-25% of patients with RA – associated with strong seropositivity; – implies aggressive disease with poor prognosis; – may occur in benign … Read more
– See: Rheumatoid Hand – Sites of Triggering in the Rheumatoid Patient: – A1 pulley (as w/ convential trigger finger) – FDS decussation (may require excising slip of sublimis or an intratendinous nodule); – nodule in FDP near A2 can cause finger to lock into extension; – Non Operative … Read more
– See: – Caput Ulnae Syndrome – Rheumatoid Hand – Wrist Arthrodesis – Discussion: – wrist involvement w/ RA is common; – findings inlude peri-articular osteoporosis, destructive osteolysis, arthritis of distal RU joint, and carpal arthrosis; – final pattern is … Read more
– See: Rheumatoid Arthritis – Pathoanatomy: – RA Disease in the Wrist – Extensor Tendon Rupture – Tenosynovitis – diff dx: w/ RF negative tenosynovitis consider myobacterium marium infection; – Flexor Tendon Rupture – Ulnar drift – MP joint – PIP … Read more
– See: Traumatic Gamekeeper’s Thumb – Discussion: – characterized by abduction deformity of MCP joint; – results from attenuation of ulnar collateral ligament; – there is also an adduction contracture of the metacarpal; – Exam: – stability of the MCP joint should be tested by applying an ulnarly directed force to joint, both … Read more
– See: – Rheumatoid Hand – MP Ulnar Drift – Deformites of MP Joints; – approximately 40% of pts w/ RA will have intrinsic contracture; – in some cases the intrinsic contracture will result from MP joint dislocation, and in other cases, the intrinsic contracture will … Read more
– See: – Rheumatoid Boutonniere – RA – Swan Neck Deformity – Arthrodesis: of PIP – expect improved key pinch strength w/ fusion of PIP joint of index finger; – arthroplasty of PIP joint of index is least successful … Read more
– See: – Boutonniere Injuries – Menu – Thumb Boutonniere Deformity – Discussion: – rheumatoid boutonniere deformity begins w/ PIP synovitis & elongation capsule; – inflammation leads to lengthening of central extensor slip and triangular ligament (becoming dysfunctional) and volar displacement of the lateral bands … Read more
– PreOperative Considerations and Implant Selection: – work up of the painful TKR: – Hip and Knee Infiltration Technique – Local Analgesia Infiltration Techniques – Hip and Knee Arthroplasty – Exposure for Revision Arthroplasty: – surgical approach for primary TKR – intraoperative gram stain, frozen section, and culture – The Routine Use … Read more
– See: – FDP rupture – FPL rupture – Teno-synovectomy – Discussion: – when flexor tendon ruptures occur, there are two usual causes: – attrition or direct invasion by tenosynovitis; – these occur in carpal canal due to invasion or attrition; – scaphoid bone … Read more